A Vague Presentation of Bilateral Chemodectomata

Andrew J Diver, Trishna Rao, William Harris, and Clive Majury

A 54 year old female was referred with a vague symptom of something moving in the right side of her neck on bending over. Asymmetry of her oral pharynx was noted, the right tonsillar bed appearing fuller than the left. Ultrasound scan of the neck revealed a right sided mass which was almost missed because of its large size. An additional mass was seen in the left anterior triangle. CT scanning demonstrated the rare condition of bilateral chemodectomata. The left tumour measured 1.5cm x 2cm x 2.5cm but the right sided disease was more extensive with dimensions 2cm x 4cm x 7cm. The latter also extended to the jugular foramen, just short of intracranial involvement. It is worth noting this lady's vague symptoms at presentation and that if a mass is larger than the ultrasound probe diameter, its boundary may be missed on scanning. Ultrasound is the initial nvestigation of choice in such vague cases because it is non-invasive but, if it fails to answer the clinical question, CT scanning is then recommended.